JP7210177B2 - パルス電力を使用する組織厚さ - Google Patents

パルス電力を使用する組織厚さ Download PDF

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Publication number
JP7210177B2
JP7210177B2 JP2018137446A JP2018137446A JP7210177B2 JP 7210177 B2 JP7210177 B2 JP 7210177B2 JP 2018137446 A JP2018137446 A JP 2018137446A JP 2018137446 A JP2018137446 A JP 2018137446A JP 7210177 B2 JP7210177 B2 JP 7210177B2
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Prior art keywords
tissue
pulse
electrode
temperature
distal portion
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Japanese (ja)
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JP2019022660A (ja
Inventor
アサフ・ゴバリ
イスラエル・ジルバーマン
アンドレス・クラウディオ・アルトマン
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Biosense Webster Israel Ltd
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Biosense Webster Israel Ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4245—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
    • A61B8/4263—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient using sensors not mounted on the probe, e.g. mounted on an external reference frame
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4272—Details of probe positioning or probe attachment to the patient involving the acoustic interface between the transducer and the tissue
    • A61B8/429—Details of probe positioning or probe attachment to the patient involving the acoustic interface between the transducer and the tissue characterised by determining or monitoring the contact between the transducer and the tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206—Generators therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A61B2018/00357—Endocardium
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00702—Power or energy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00738—Depth, e.g. depth of ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00791—Temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/102—Modelling of surgical devices, implants or prosthesis
    • A61B2034/104—Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2051—Electromagnetic tracking systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A61B2090/065—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/002—Irrigation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/01—Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1076—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions inside body cavities, e.g. using catheters

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Otolaryngology (AREA)
  • Pathology (AREA)
  • Biophysics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Cardiology (AREA)
  • Acoustics & Sound (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Surgical Instruments (AREA)
JP2018137446A 2017-02-10 2018-07-23 パルス電力を使用する組織厚さ Active JP7210177B2 (ja)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US201762457266P 2017-02-10 2017-02-10
US201762470983P 2017-03-14 2017-03-14
US15/657,270 US11147610B2 (en) 2017-02-10 2017-07-24 Tissue thickness using pulsed power
US15/657,270 2017-07-24

Publications (2)

Publication Number Publication Date
JP2019022660A JP2019022660A (ja) 2019-02-14
JP7210177B2 true JP7210177B2 (ja) 2023-01-23

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JP2018137446A Active JP7210177B2 (ja) 2017-02-10 2018-07-23 パルス電力を使用する組織厚さ

Country Status (7)

Country Link
US (1) US11147610B2 (fr)
EP (1) EP3434214B1 (fr)
JP (1) JP7210177B2 (fr)
CN (1) CN109288584B (fr)
AU (1) AU2018204091A1 (fr)
CA (1) CA3010943A1 (fr)
IL (1) IL260238B (fr)

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11589918B2 (en) 2019-04-08 2023-02-28 Biosense Webster (Israel) Ltd. System and method for temperature control in irrigated ablation
CN111557734B (zh) * 2020-05-07 2021-11-02 徐州佳智信息科技有限公司 一种基于vr场景的激光消融导航系统
CN117958956B (zh) * 2024-04-01 2024-06-18 四川大学华西医院 一种射频消融导管及用于射频消融导管的混合控制系统

Citations (3)

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Publication number Priority date Publication date Assignee Title
US20020173784A1 (en) 1996-10-22 2002-11-21 Epicor, Inc. Methods and devices for ablation
US20140039489A1 (en) 2008-04-29 2014-02-06 Virginia Tech Intellectual Properties, Inc. Acute blood-brain barrier disruption using electrical energy based therapy
JP2014516623A (ja) 2011-04-13 2014-07-17 セント ジュード メディカル インコーポレイテッド 層状および非層状組織における熱アブレーションによる病変部形成のパルスエコーモニタリングおよび制御、カテーテル接触モニタリング、組織の厚さ測定、およびプレポップ警告用の音響変換器

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US8333764B2 (en) 2004-05-12 2012-12-18 Medtronic, Inc. Device and method for determining tissue thickness and creating cardiac ablation lesions
US7869865B2 (en) 2005-01-07 2011-01-11 Biosense Webster, Inc. Current-based position sensing
US7848787B2 (en) 2005-07-08 2010-12-07 Biosense Webster, Inc. Relative impedance measurement
US20070049915A1 (en) 2005-08-26 2007-03-01 Dieter Haemmerich Method and Devices for Cardiac Radiofrequency Catheter Ablation
US8221405B2 (en) 2006-02-06 2012-07-17 Coherex Medical, Inc. Patent foramen ovale closure device and methods for determining RF dose for patent foramen ovale closure
US8402974B2 (en) * 2006-05-30 2013-03-26 Coherex Medical, Inc. Methods, systems, and devices for sensing, measuring, and controlling closure of a patent foramen ovale
US9033885B2 (en) 2008-10-30 2015-05-19 Vytronus, Inc. System and method for energy delivery to tissue while monitoring position, lesion depth, and wall motion
US8388549B2 (en) * 2008-12-29 2013-03-05 St. Jude Medical, Atrial Fibrillation Division, Inc. Anatomical thermal sensing device and method
US20110022041A1 (en) * 2009-07-24 2011-01-27 Frank Ingle Systems and methods for titrating rf ablation
WO2012142291A1 (fr) * 2011-04-12 2012-10-18 Thermedical, Inc. Dispositifs et procédés de mise en forme d'un traitement dans une élimination amplifiée de liquide
US9297845B2 (en) * 2013-03-15 2016-03-29 Boston Scientific Scimed, Inc. Medical devices and methods for treatment of hypertension that utilize impedance compensation
US11096736B2 (en) * 2013-12-09 2021-08-24 Biosense Webster (Israel) Ltd. Pericardial catheter with temperature sensing array
US9956035B2 (en) 2014-03-27 2018-05-01 Biosense Webster (Israel) Ltd. Temperature measurement in catheter
US20160166309A1 (en) * 2014-12-12 2016-06-16 Balasubramanian K V Method and System for Determining Ablation Parameters for Ablating a Tissue
US10327734B2 (en) * 2014-12-30 2019-06-25 Biosense Webster (Israel) Ltd. Measurement of tissue thickness using ultrasound and force measurements
US10517670B2 (en) 2015-07-16 2019-12-31 Biosense Webster (Israel) Ltd. Estimation of lesion size
JP6445742B1 (ja) 2015-10-21 2018-12-26 セント・ジュード・メディカル，カーディオロジー・ディヴィジョン，インコーポレイテッド 高密度電極マッピングカテーテル
US10792097B2 (en) * 2015-12-03 2020-10-06 Biosense Webster (Israel) Ltd. Ablation line contiguity index

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20020173784A1 (en) 1996-10-22 2002-11-21 Epicor, Inc. Methods and devices for ablation
US20140039489A1 (en) 2008-04-29 2014-02-06 Virginia Tech Intellectual Properties, Inc. Acute blood-brain barrier disruption using electrical energy based therapy
JP2014516623A (ja) 2011-04-13 2014-07-17 セント ジュード メディカル インコーポレイテッド 層状および非層状組織における熱アブレーションによる病変部形成のパルスエコーモニタリングおよび制御、カテーテル接触モニタリング、組織の厚さ測定、およびプレポップ警告用の音響変換器

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Publication number Publication date
EP3434214A1 (fr) 2019-01-30
IL260238A (en) 2018-10-31
CN109288584A (zh) 2019-02-01
AU2018204091A1 (en) 2019-02-07
IL260238B (en) 2021-06-30
CN109288584B (zh) 2023-04-14
JP2019022660A (ja) 2019-02-14
US20180228529A1 (en) 2018-08-16
CA3010943A1 (fr) 2019-01-24
US11147610B2 (en) 2021-10-19
EP3434214B1 (fr) 2020-07-01

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